未通过早产儿视网膜病变眼底筛查患儿远期眼部异常的跟踪与随访分析

Follow-up analysis of long-term eye abnormality of premature infants failing in fundus screening of retinopathy

目的:探讨未通过早产儿视网膜病变(ROP)眼底筛查新生儿的眼底及远期眼部异常随访的意义。方法:回顾性分析56例合并ROP患儿的围产期病史及远期眼部异常的发生情况。结果:视网膜完全血管化的时间ROP轻度组为生后(63.3±24.5)天;阈值前病变组为(52.0±12.4)天;ROP重度组为(55.0)±16.9天;ROP轻度组胎龄、出生体重、平均吸氧时间(F iO2>45.0%)与阈值前病变组及ROP重度组比较差异有显著性(P<0.05);阈值前病变组与ROP重度组比较,胎龄、平均吸氧时间(F iO2>45.0%)差异有显著性(P<0.05);6年后的随访早产儿的其他眼部异常的发生率与ROP的程度成正相关。结论:小胎龄、长时间高浓度的吸氧为ROP的预后的重要危险因素,阈值前病变及重度ROP早产儿远期其他眼部异常如屈光不正、弱视、斜视、的发生率较高。

Objective：To explore the significances of fundus follow-up and long-term eye abnormality follow-up of premature infants failing in fundus screening of retinopathy.Methods：The medical histories and the occurrences of long-term eye abnormality of 56 premature infants with retinopathy of prematurity（ROP） were analyzed retrospectively.Results：The times of complete retinal vascularization in mild ROP group,prethreshold ROP group and severe ROP group were（63.3±24.5） days,（52.0±12.4） days and（55.0±16.9） days,respectively;there was significant difference in gestational age,birth weight and average oxygen time（FiO2〉45%） between mild ROP group and prethreshold ROP group,severe ROP group（P〈0.05）;there was significant difference in gestational age and average oxygen time（FiO2〉45%） between prethreshold ROP group and severe ROP group（P〈0.05）;the follow-up after 6 years showed that there was a positive correlation between the incidences of other eye abnormalities of premature infants and the grades of ROP.Conclusion：Young gestational age and long-term oxygen therapy（FiO2〉45%） are the important risk factors of prognosis of ROP,the premature infants with prethreshold ROP and severe ROP have high incidences of other eye abnormalities,such as ametropia,amblyopia and strabismus.